Iordanskii Force and the Gravitational Aharonov-Bohm effect for a Moving Vortex

I discuss the scattering of phonons by a vortex moving with respect to a superfluid condensate. This allows us to test the compatibility of the scattering-theory derivation of the Iordanskii force with the galilean invariance of the underlying fluid dynamics. In order to obtain the correct result we must retain $O(v_s^2)$ terms in the sound-wave equation, and this reinforces the interpretation, due to Volovik, of the Iordanskii force as an analogue of the gravitational Bohm-Aharonov effect.Comment: 20 pages, LaTe

COVID-19 in People with Diabetes: Urgently Needed Lessons from Early Reports

Epidemic infections have frightened and harmed people for millennia. Plague and typhus, bacterial infections associated with poor sanitation and high mortality, have devastated populations. Both still reappear intermittently, but they are generally contained with better sanitation and control of rodent and insect vectors along with antibiotics. In contrast, viral epidemics persist. A unique strain of influenza caused a global epidemic (pandemic) in 1918 resulting in millions of deaths. Among recent outbreaks of viral infections, several have been caused by coronaviruses. One of these, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is now causing a pandemic illness termed coronavirus disease 2019 (COVID-19) that poses unique challenges. This novel coronavirus is readily transmitted from person-to-person, even by thosewho are infected but without symptoms. In susceptible people it causes severe illness and often death from pulmonary and systemic injuries. At present, we have neither a preventive vaccine nor well-studied pharmacotherapy, although work to develop these is vigorously underway

"i was able to eat what i am supposed to eat" - Patient reflections on a medically-tailored meal intervention: A qualitative analysis

Background: Medically-tailored meal programs that provide home-delivered medically-appropriate food are an emerging intervention when type 2 diabetes co-occurs with food insecurity (limited or uncertain access to nutritious food owing to cost). We sought to understand the experiences of medically-tailored meal program participants. Methods: We conducted semi-structured interviews with participants in a randomized trial of medically-tailored meals (NCT02426138) until reaching content saturation. Participants were adults (age > 20 years) with type 2 diabetes in eastern Massachusetts, and the interviews were conducted from April to July 2017. Interviews were transcribed verbatim and coded by two independent reviewers. We determined emergent themes using content analysis. Results: Twenty individuals were interviewed. Their mean age was 58 (SD: 13) years, 60.0% were women, 20.0% were non-Hispanic black, and 15.0% were Hispanic. Key themes were 1) satisfaction and experience with medically-tailored meals 2) food preferences and cultural appropriateness, 3) diabetes management and awareness, and 4) suggestions for improvement and co-interventions. Within these themes, participants were generally satisfied with medically-tailored meals and emphasized the importance of receiving culturally appropriate food. Participants reported several positive effects of medically-tailored meals, including improved quality of life and ability to manage diabetes, and stress reduction. Participants suggested combining medically-tailored meals with diabetes self-management education or lifestyle interventions. Conclusions: Individuals with diabetes and food insecurity expressed satisfaction with the medically-tailored meal program, and reported that participation reduced stress and the burden of diabetes management. Suggestions to help ensure the success of medically-tailored meal programs included a strong emphasis on culturally acceptability and accommodating taste preferences for provided foods, and combining medically-tailored meals with diabetes education or lifestyle intervention. Trial registration: ClinicalTrials.gov NCT02426138

Medically Tailored Meal Delivery for Diabetes Patients with Food Insecurity: a Randomized Cross-over Trial

Background: Food insecurity, defined as inconsistent food access owing to cost, leads to poor health. Objective: To test whether a medically tailored meal delivery program improved dietary quality in individuals with type 2 diabetes and food insecurity. Design: Randomized cross-over clinical trial. Participants: Forty-four adults with diabetes, hemoglobin A1c > 8.0%, and food insecurity (defined as at least one positive item on the two-item “Hunger Vital Sign”). Intervention: In the Community Servings: Food as Medicine for Diabetes cross-over clinical trial (NCT02426138), conducted from June 2015 to July 2017, we randomly assigned the order of “on-meals” (home delivery of 10 meals/week for 12 weeks delivered by Community Servings, a non-profit organization) and “off-meals” (12 weeks usual care and a Choose MyPlate healthy eating brochure) periods. Main Measures: The primary outcome was Healthy Eating Index 2010 score (HEI), assessed by three 24-h food recalls in both periods. Higher HEI score (range 0–100; clinically significant difference 5) represents better dietary quality. Secondary outcomes included food insecurity and self-reported hypoglycemia. Key Results: Mean “on-meal” HEI score was 71.3 (SD 7.5) while mean “off-meal” HEI score was 39.9 (SD 7.8) (difference 31.4 points, p < 0.0001). Participants experienced improvements in almost all sub-categories of HEI score, with increased consumption of vegetables, fruits, and whole grains and decreased solid fats, alcohol, and added sugar consumption. Participants also reported lower food insecurity (42% “on-meal” vs. 62% “off-meal,” p = 0.047), less hypoglycemia (47% “on-meal” vs. 64% “off-meal,” p = 0.03), and fewer days where mental health interfered with quality of life (5.65 vs. 9.59 days out of 30, p = 0.03). Conclusions: For food-insecure individuals with diabetes, medically tailored meals improved dietary quality and food insecurity and reduced hypoglycemia. Longer-term studies should evaluate effects on diabetes control (e.g., hemoglobin A1c) and patient-reported outcomes (e.g., well-being)

Food insecurity, food "deserts," and glycemic control in patients with diabetes: A longitudinal analysis

OBJECTIVE Both food insecurity (limited food access owing to cost) and living in areas with low physical access to nutritious foods are public health concerns, but their relative contribution to diabetes management is poorly understood. RESEARCH DESIGN AND METHODS This was a prospective cohort study. A random sample of patients with diabetes in a primary care network completed food insecurity assessment in 2013. Low physical food access at the census tract level was defined as no supermarket within 1 mile in urban areas and 10 miles in rural areas. HbA1c measurements were obtained from electronic health records through November 2016. The relationship among food insecurity, low physical food access, and glycemic control (as defined by HbA1c) was analyzed using hierarchical linear mixed models. RESULTS Three hundred and ninety-one participants were followed for a mean of 37 months. Twenty percent of respondents reported food insecurity, and 31% resided in an area of low physical food access. In adjusted models, food insecurity was associated with higher HbA1c (difference of 0.6%[6.6mmol/mol], 95% CI 0.4-0.8[4.4-8.7],P&lt;0.0001), which did not improve over time (P = 0.50). Living in an area with low physical food access was not associated with a difference in HbA1c (difference 0.2%[2.2mmol/mol], 95% CI 20.2 to 0.5 [22.2 to 5.6], P = 0.33) or with change over time (P = 0.07). CONCLUSIONS Food insecurity is associated with higher HbA1c, but living in an area with low physical food access is not. Food insecurity screening and interventions may help improve glycemic control for vulnerable patients

Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium–glucose cotransporter-2 (SGLT2) inhibitor or a glucagon-like peptide-1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit is recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication